Step 2. Prepare to give abdominal thrusts if the child nods yes and is unable to cough or talk, or if cough becomes very weak. Tell the child you are going to help.
• Child may clutch throat to indicate choking. • Choking is scary for the child and the caregiver.
Step 3. If you have a cell phone with you, call 9-1-1, put the phone on speakerphone, and place the phone on the ground so that your hands are free.
• If you do not have a cell phone, ask anyone who can to call 9-1-1 for help. A spouse, child’s sibling, or someone else in the home may be able to call 9-1-1.
• If you are alone, do not delay rescue attempts to make the call.
Step 4. Get in position to give abdominal thrusts. Kneel or stand behind the child and put your arms around the child’s body making sure your arms are under the child’s arms and below the child’s ribs.
• Kneel or stand behind the child so abdominal thrusts will be effective. Putting the child on your lap won’t work.
Step 5. Give up to 5 abdominal thrusts. Make a fist with one hand. Place thumb of your fist slightly above the child’s belly button and well below the lower tip of breastbone. Grasp your fist with your other hand and “cough” for the child by giving up to 5 quick, forceful, upward abdominal thrusts. Say out loud, “Cough! Cough! Cough! Cough! Cough!”
• Correct positioning of hands and arms will prevent damage to soft organs under the ribs.
• Abdominal thrusts are inward and upward, like scooping ice cream.
• The directions say to give up to 5 abdominal thrusts because if the object comes out before 5 abdominal thrusts, you stop.
Step 6. After every 5 abdominal thrusts: Check your hands to be sure they are in the correct position — slightly above the belly button and well below the lower tip of the breastbone. Check your arms to be sure they are in the correct position under the child’s arms and below the child’s ribs. Check the condition of the child.
• As child becomes limp due to lack of oxygen, child may slip down causing rescuer’s arms to be in wrong position over the ribs. If that happens, your abdominal thrusts may not work, and you could injure the child.
Step 7. Don’t give up. Continue giving abdominal thrusts until the object is “coughed out” and the child can breathe, cough, or talk, or until the child stops responding or loses consciousness.
• Do not give up if initial attempts to relieve blocked airway aren’t successful. As child becomes weaker, muscles relax, and abdominal thrusts may become more effective.
Step 8. If the child loses consciousness and you haven’t yet called 9-1-1, lower the child to the ground face-up and call 9-1-1 for further instructions.
GRANDPARENTS: GETTING STARTED INSTRUCTOR MANUAL | PAGE 19
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